Shaken Baby Syndrome

目的：在孩童身體虐待中，嬰兒搖晃症已被証實最嚴重的型式之一。此已引起臨床醫師及學者的注意。但在缺乏細心的偵察及診斷之下，嬰兒或年幼的孩童當遭受嬰兒搖晃的施虐時，可能常被忽略，並且照顧者或其父母親常能夠逃避法律上的控訴。個案報告：二位遭受嬰兒搖晃症的個案被送至某綜合醫院急診室，臨床檢查呈現視網膜及下硬腦膜出血，後藉由精神科、放射科、小兒科及眼科醫師以腦部電腦斷層掃瞄及其他適當檢查予以確定，並探究引發此二個案施虐者面對嬰兒激噪時挫折感、酒精濫用、婚姻上問題及慣性使用暴力等因素。結論：藉此對嬰兒搖晃症及長期預後加以探討，對於加害者及其家庭也須予整合性評估，許多保護性的策略須採用且藉由專業人士介入，才是保護受虐兒童之長久方法。

關鍵字

嬰兒搖晃症；家庭暴力；身體虐待；下硬腦膜出血

並列摘要

Objective: Shaken baby syndrome (SBS) is considered as one of the most serious forms of child physical abuse, and has drawn much attention from clinical workers and researchers. Without appropriate careful detection and diagnosis, infants or young children with SBS might be ignored. Case reports: We report two children who were admitted for investigation of subdural and retinal hemorrhage at a general hospital. The diagnosis of SBS was made based on findings from physical and laboratory examinations and brain CT scans. Physicians involved in the treatment included psychiatrists, pediatricians, and radiologists. The possible explanations for SBS in these two cases included baby's irritability, alcohol abuse, martial problems and habitual violence by adults. Conclusion: We find that, in severe infant abuse cases resulting in permanent injury or death, and inappropriate infant caring and poor social economic status are potential risk factors. Findings from these two cases indicate the need for comprehensive assessment of the perpetrators and their family members and appropriate preventive strategies.

並列關鍵字

shaken baby syndrome ； family violence ； physical abuse ； subdural hemorrhage

參考文獻

Alexander R,Sato Y,Smith W(1990).Bennett T Incidence of trauma with cranial injuries ascribed to shaking.Am J Dis Child.144,724-726.

Google Scholar

American Academy of Pediatrics Committee on Child Abuse and Neglect(2001).Shaken baby syndrome: rotational cranial injuries-technical report.Pediatrics.108,206-210.